Like anyone else, people who are temporarily confined in city and county jails can have health problems, such as cancer, diabetes or kidney disease.

More unusual situations sometimes result from incarceration. Georgia inmates have had their jaws broken, and eyes poked with pencils in jailhouse fights.

Whatever their medical issues, inmates and their health are a government responsibility. In most cases, taxpayers pay the medical bills.

Little wonder then, many Georgia cities are joining a new insurance program, offering protection from catastrophic medical bills for inmates.

The program, administered by the Georgia Municipal Association, became available to more than 300 cities this month.

Cities are responsible for paying up to $10,000 per inmate, per year. Beyond that, the policy covers up to $250,000 per inmate for each arrest period, said Amy Henderson, a spokeswoman for the municipal association. The premium is already covered by the cities' membership in the existing municipal insurance pool.

A similar policy for county jail inmates has been available for several years to county governments through the Association County Commissioners of Georgia.

The policy for cities, made available through Correctional Risk Services Inc., of Brentwood, Tenn., covers outpatient surgery, inpatient hospitalization, physician fees and diagnostic services. Among the ailments covered are chest pains and heart attacks, kidney disease or appendicitis, and self-inflicted injuries or those sustained in jailhouse fights.

In addition to the insurance, the program includes company monitoring of medical bills for accuracy and to secure group discounts, said Steve Kreal, president of Correctional Risk Services. The company says it saves most communities about 25 percent on medical bills.

"All we're trying to do is reduce the outside medical costs for inmates and provide an insurance policy, so the municipality's budget isn't busted," he said.

About 30 cities have signed up since the insurance became available this month, according to the municipal association.

For cities such as Sandy Springs, the protection is a no-brainer.

The city of 90,000 people doesn't even have its own jail. The people it arrests are sent to either the Doraville city jail or a county lockup in Irwin County. But the city is still responsible for its inmates. And their medical bills have increased over the past two years.

Sandy Springs taxpayers will pay more than $60,000 for inmate medical bills this year, double the amount paid last year.

"For us, it's a big deal," said Steve Rapson, the assistant city manager.

In Athens, the combined county/city government also is interested in joining, said Manager Alan Reddish.

One of the factors city officials considered was whether the insurance would cover detainees —people arrested but not yet taken to a jail.

A few years ago, Reddish said, police in Athens arrested someone who claimed to have swallowed several bags of cocaine. After taking him to a local hospital, police were told that wasn't true. But had the man swallowed the drug, his hospital expenses would have fallen on local taxpayers, and likely would have exceeded $10,000, Reddish said.

"Sometimes, in detaining people, if there's a chase involved, or a struggle," the suspect can get injured, Reddish said. "If the person gets injured, we're going to take them to the hospital."

County jails typically are larger than city lockups and hold inmates facing the most serious charges. In Fulton County, for example, the county jail takes in people charged with felony crimes. Even more than cities, counties have been on the receiving end of increasing inmate medical expenses, said Jerry Griffin, executive director of the Association County Commissioners of Georgia.

A challenge for counties, and now cities, is budgeting appropriately for inmate medical expenses. Without insurance, the bills can be unpredictable, Griffin said. Most inmates are not covered by personal insurance, he said.

Counties using insurance through their association have been reimbursed for unexpected calamities, including attempted suicides and injuries resulting from jailhouse fights.

"We have worked for a long time to provide some kind of health coverage, or stopgap coverage, for inmates," he said. "The problem is it's an unpredictable kind of thing, and let's face it, the kind of people who end up incarcerated, have not led the most wonderful kind of lifestyle."

Costly patients

Medical claim examples, provided by the Association County Commissioners of Georgia:

Broken jaw from a fight on the basketball court, $31,000.

Attempted suicide, resulting in suffocation, $37,741.

Intentional pencil in the eye, $78,000.

Self-inflicted stabbing, $93,300.

Breast cancer, female inmate, $118,000.

Injuries from two-story jump off roof, $125,000.

Kidney failure (pre-existing condition), $183,000.

Ingested battery acid, $188,000